局部晚期食管癌同步放化疗疗效及预后的影响因素
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Factors influencing the efficacy and prognosis of concurrent radiochemo-therapy in locally advanced esophageal cancer
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    摘要:

    目的:探讨局部晚期食管癌同步放化疗疗效及预后的影响因素。方法:选取120例行同步放化疗的局部晚期食管癌患者为研究对象,依据近期疗效分为缓解组(n=87)和未缓解组(n=33)。评价同步放化疗的近期疗效和远期预后;Logistic回归分析影响近期疗效的因素;Kaplan-Meier生存分析和COX回归分析影响远期预后的因素。结果:完全缓解23例(19.17%),部分缓解64例(53.33%),客观缓解率为72.50%。Logistic回归分析显示,未缓解组患者T4期、淋巴结转移、高分化的比例高于缓解组(P<0.05),且T4期(OR:3.337,95%CI:1.308~8.515)、淋巴结转移(OR:4.216,95%CI:1.457~12.199)、高分化(OR:5.772,95%CI:2.162~15.409)是同步放化疗未达到缓解的危险因素(P<0.05)。随访5.8~60.0个月,中位随访期为37.4个月,随访期死亡73例(60.83%),存活47例(39.17%)。Kaplan-Meier生存分析显示,不同T分期、淋巴结转移情况、分化程度的累积生存率比较,T3期(44.23%)>T4期(17.96%),无淋巴结转移(58.76%)>有淋巴结转移(16.99%),高分化(51.37%)>中分化(22.06%)>低分化(5.68%),差异均有统计学意义(P<0.05)。COX回归分析显示,T4期(HR:2.219,95%CI:1.142~4.312)、淋巴结转移(HR:2.809,95%CI:1.246~6.337)、低分化(HR:3.360,95%CI:1.458~7.744)是局部晚期食管癌患者预后差的危险因素(P<0.05)。结论:同步放化疗是治疗局部晚期食管癌的有效方法,T分期、淋巴结转移情况和分化程度是影响同步放化疗疗效的影响因素,而T4期、淋巴结转移、低分化更容易导致较差的预后。

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    Objective:To investigate the efficacy and prognosis of concurrent radiochemotherapy in locally advanced esophageal cancer,and analyze the influencing factors.Methods:A total of 120 patients with locally advanced esophageal cancer who underwent concurrent radiochemotherapy were selected.The short-term efficacy and long-term prognosis of concurrent radiochemotherapy were e-valuated.Logistic regression analysis was used to explore factors influencing short-term efficacy.Kaplan-Meier survival analysis and COX regression analysis were used to explore factors influencing long-term prognosis.Results:There was complete remission in 23 cases(19.17%),partial remission in 64 cases(53.33%).The objective remission rate was 72.50%.Logistic regression analysis showed that proportions of T4 stage,lymph node metastasis and well differentiation in the non-remission group were higher than those in the re-mission group(P<0.05).T4 stage(OR:3.337,95%CI:1.308~8.515),lymph node metastasis(OR:4.216,95% CI:1.457~12.199)and well differentiation(OR:5.772,95% CI:2.162~15.409)were risk factors for no remission after concurrent radioche-motherapy(P<0.05).The patients were followed up for 5.8~60.0 months,with a median follow-up period of 37.4 months,73 pa-tients(60.83%)died and 47 patients(39.17%)survived.Kaplan-Meier survival analysis showed that T3 stage(44.23%)was higher than T4 stage(17.96%),and without lymph node metastasis(58.76%)was higher than lymph node metastasis(16.99%).The cumulative survival rate of patients with high differentiation(51.37%),moderate differentiation(22.06%),and poor differentia-tion(5.68%)decreased in order(P<0.05).COX regression analysis showed that T4 stage(HR:2.219,95%CI:1.142~4.312),lymph node metastasis(HR:2.809,95%CI:1.246~6.337),and poor differentiation(HR:3.360,95% CI:1.458~7.744)were risk factors for poor prognosis in patients with locally advanced esophageal cancer(P<0.05).Conclusion:Concurrent radiochemother-apy is an effective method for treating locally advanced esophageal cancer.T staging,lymph node metastasis status and differentiation degree are influencing factors on the efficacy of concurrent radiochemotherapy.T4 stage,lymph node metastasis and poor differentiation are more likely to lead to poor prognosis.

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翟红艳;李建华;张娜;.局部晚期食管癌同步放化疗疗效及预后的影响因素[J].川北医学院学报,2025,40(7):927-930 942.

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  • 在线发布日期: 2025-08-10
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